Two leading Academic Cancer Centers found that proton therapy can potentially increase overall survival and reduce treatment related toxicities versus traditional photon radiation therapy for patients with inoperable hepatocellular carcinoma (HCC).
A team led by Dr. Nina Sanford, assistant professor of radiation oncology at the University of Texas Southwestern Medical Center, analyzed survival and side effect data of patients with HCC who were treated at Massachusetts General Hospital between 2008 and 2017, 37% of whom were treated with proton therapy.
While both treatments provided similar tumor control, patients treated with protons had a much lower risk of treatment-related liver diseases. This translated to longer median survival outcomes than patients treated with photons.
“The main finding of the study was that proton radiotherapy was associated with improved overall survival,” said Sanford. “The median overall survival of patients treated with protons versus photons was 31 and 14 months, respectively.”
The overall survival rate for proton therapy patients at 24 months was 59.1%, over double the 28.6% found for patients who received traditional photon radiation. Additionally, the risk of radiation induced liver disease (RILD) was 74% lower in the proton group.
Dr. Cheng-Eh Hsieh led teams at MD Anderson Cancer Center and Chang Gung University in Taoyuan City, Taiwan that examined factors that correlate to RILD. Their team found the most important factor in determining the risk of RILD was the volume of liver exposed to radiation. Less radiation to healthy tissue resulted in lower rates of RILD.
“Protons contain unique physical properties that allow doctors to stop the radiation inside the tumor target thus sparing significant volumes of healthy tissue from radiation exposure as compared to traditional photon radiation techniques that use X-Rays such as IMRT,” said Dr. John Chang, Medical Director of the Oklahoma Proton Center and a leading expert in the field
of radiation oncology.
“Our goal as radiation oncologists should always be to deliver more radiation to the tumor and less radiation to healthy tissue,” continued Dr. Chang. “Proton therapy is almost always the best option to accomplish this for many cancers.”
Dr Andrzej Wojcieszynski and Dr. Edgar Ben-Josef of the University of Pennsylvania provided an accompanying editorial to the studies: “The dosimetric advantages of proton therapy over photon therapy are indisputable. These two studies show that radiation can treat liver tumors with a high degree of local control and safety, and proton therapy is clearly a powerful tool in the treatment of HCC.”
For patients interested in learning more about proton therapy for liver or other cancers, Dr. John Chang recommends reaching out to the team at Oklahoma Proton Center.
“We have successfully treated thousands of patients with protons since the center opened in 2009, including liver cancer cases. We encourage any patient or family member with questions to reach out to our team. We can provide an initial clinical review of a case within a few days and provide a recommendation on whether proton therapy is an option worth considering.”